Healthcare Provider Details

I. General information

NPI: 1346529229
Provider Name (Legal Business Name): KRISTEN MARIE KOWALSKI AU.D., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2011
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 OXBOW DR
ALPENA MI
49707-1448
US

IV. Provider business mailing address

1114 CHARLEVOIX AVE
PETOSKEY MI
49770-9701
US

V. Phone/Fax

Practice location:
  • Phone: 231-489-8151
  • Fax: 231-668-7794
Mailing address:
  • Phone: 231-489-8151
  • Fax: 231-668-7794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000580
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: